What are the potential side effects of topical corticosteroids used in the management of discoid eczema?

Topical corticosteroids used in the management of discoid eczema can cause several potential side effects. Continuous use of potent or very potent corticosteroids may lead to irreversible skin atrophy and striae. They can also cause the eczema to become unstable and may result in systemic side effects, especially when applied continuously to extensive areas of skin (for example, more than 10% of body surface area). To minimize these risks, breaks of at least 4 weeks between courses of potent or very potent corticosteroids are recommended, and treatment duration should be limited (no longer than 4 weeks for very potent and 8 weeks for potent corticosteroids). In children, potent corticosteroids should be used for as short a time as possible and not on the face or neck, with specialist supervision for children under 12 months. Additionally, there is a risk of tachyphylaxis (reduced response) with prolonged use. Regular review is advised to monitor for steroid atrophy and other adverse effects.